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In response to environmental, economic, and social challenges, the living labs approach to innovation is receiving increasing attention within the agricultural sector. In this paper, we propose a set of defining characteristics for an emerging type of living lab intended to increase the sustainability and resilience of agriculture and agri-food systems: the “agroecosystem living lab”. Drawing on first-hand knowledge of case studies of large initiatives from Canada and France and supported by eight other cases from the literature, we highlight the unique nature of agroecosystem living labs and their distinct challenges with respect to their aims, activities, participants, and context. In particular, these living labs are characterized by exceptionally high levels of scientific research; long innovation cycles with high uncertainty due to external factors; and the high number and diversity of stakeholders involved. Both procedurally and conceptually, we link to earlier efforts undertaken by researchers seeking to identify urban living labs and rural living labs as distinct, new types of living labs. By highlighting what makes agroecosystem living labs unique and their commonalities with other types of living labs, we hope to encourage their further study and help practitioners better understand their implementation and operational challenges and opportunities. Full article

Tuberculosis remains a serious health problem worldwide. Patients with tuberculosis who also require nursing care due to aging and underlying diseases are considered to have a high mortality rate; however, there are few studies describing detailed examinations of such disease conditions. Objective: The present study was conducted to investigate differences in clinical features of elderly tuberculosis patients according to the levels of nursing and healthcare required. Design: The study participants included 146 elderly (≥65 years) patients diagnosed with active tuberculosis among patients hospitalized with tuberculosis at a single center. The patients were classified into two groups: a nursing- and healthcare-associated tuberculosis group (n = 71) and a community-acquired tuberculosis group (n = 75). Results: The nursing- and healthcare-associated tuberculosis patients were older and had a higher frequency of comorbidities compared with the community-acquired tuberculosis group. Patients in the nursing- and healthcare-associated tuberculosis group had markedly lower levels of serum albumin and hemoglobin, and higher levels of C-reactive protein. The rate of in-hospital death was significantly higher in the nursing- and healthcare-associated tuberculosis group. This was attributed to malnutrition and comorbid conditions rather than the severity of tuberculosis. Conclusion: The prognosis was poor in elderly tuberculosis patients receiving nursing and healthcare. Full article